Sports specialization has become increasingly common amongst young athletes, as have the rates of both orthopedic injuries and major injuries such as ACL tears. These concerning trends are not coincidental, reports Mininder Kocher, MD, M.P.H, an orthopedic surgeon and the associate director of Boston Children’s Sports Medicine Division, in a recent presentation to the American Academy of Orthopedic Surgeons (AAOS).

Sometimes for a parent of a preschooler, it seems like bedtime cannot come soon enough, especially after a particularly challenging day. But while an early bedtime for young children may mean a break for harried parents, it can also have a positive impact on children’s health, even years later.

In a recent article published in The Journal of Pediatrics, researchers Anderson, Andridge and Whitaker studied over 900 children between the ages of 3 and 5 years as part of a large national long-term study, Early Child Care and Youth Development. They found that about a quarter of the children had average bedtimes after 9pm as reported by parents, while another 25% had bedtimes before 8pm. When re-examined at around age 15 years, height and weight were measured in these same children and compared to age and gender-specific norms. The teens with late bedtimes as preschoolers were more than twice as likely to be obese compared to those with an early bedtime, even after accounting for known obesity-related factors such as birthweight and mother’s weight. The rate of obesity for the “intermediate bedtime” group (16%) was between that of the early and late bedtime groups (10% and 23% respectively). …Read More

When a previously healthy-weight child comes in with a high body mass index (BMI) — especially above the 85 percentile — the ensuing discussion can be one of the most delicate conversations we have with our families. We need to open a dialog in a way that won’t alienate the parent or child so they will feel comfortable returning for this problem.

If this is the first conversation about a BMI problem, my main goal is to identify why the child’s weight has increased (Change in diet? Change in exercise?) and suggest changes in ways that encourage the patient to return in a month. I try to balance the conversation with information, understanding and hope, pointing out that making some changes over the next month may make a difference.

But how do you find an opening to get the conversation started? …Read More

Pediatric obesity has become a national public health crisis over the last decade, with the U.S. Centers for Disease Control and Prevention (CDC) recording rates of childhood obesity as high as 17 percent nationwide. This does not make the individual conversation with families about obesity and its consequences any simpler. In fact, the widespread nature of this problem has served to normalize it in society and often complicates the discussions and motivation for treatment. However, the dire potential consequences of childhood obesity mandate that we as pediatricians work to prevent as well as diagnosis and treat this disorder. …Read More